Friday 31 May 2013

A&E Pressure

Andy Burnham, the shadow health secretary has been in Leighton Hospital yesterday as he is concerned about the care that is being offered by A&Es. He was fairly measured in his remarks when I saw him on the regional Granada news and he mentioned the ageing population as a cause of the pressure which was not the fault of any government. We also heard from Liverpool, where the A&E was forced to close over the bank holiday weekend, and that there had been an unprecedented 8% increase in demand for their services. We also learned that many A&Es were at tipping point.

Andy didn't really speak like the shadow health secretary. He hadn't criticised the government and to his credit he sounded like he was just looking for answers. Then I looked on the internet. Andy had 'warned that A&E departments are under increasing pressure, with the situation deteriorating "significantly on this Government's watch" '. Why should that be? Why was he trying to score political points on demographics that had been in place for years. Well he could have been criticising the government for not dealing with this situation over the years but he would have to include Labour governments if he did this and it is up to local NHS trusts how they organise their services. Is he saying the government should intervene? Well he didn't say that but is this what he wants?

What is the single most important reason for greater pressure on A&Es? It has to be the Labour Government's decision in 2004 to remove responsibility from GPs for their out of hours service. If the public can only rely on their GP during surgery hours then more will turn to A&E even if this is not the most appropriate course of treatment.

It used to be the case that GPs would look after their patients all the time and even if an A&E was needed then the GP would send the patient there. Then with Labour's blessing, some A&Es became minor injuries units. This may have saved money but the public is not sure what is minor and what is major. They also don't know the opening and closing times of the minor injuries units. Why should a patient take a risk and go to the wrong place when they could go straight to A&E?

One factor that I haven't mentioned is the amalgamation of neighbouring A&Es. I did not read that these units were at tipping point and this was not mentioned in the North West reports on television. How could they be? They have been recently revised in order to provide the best service. Maybe some of these units in other parts of the country have felt the pressure as Andy says "the facts on the ground are changing fast and call into question the wisdom and safety of closing so many A&Es across England." It' a pity he couldn't mention any in Granada land.

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